Vertebral Deformities and Functional Impairment in Men and Women

Burger, Huibert; Daele, P. L. A. Van; Grashuis, K.; Hofman, Albert; Grobbee, Diederick E.; Schütte, H; Jc, Birkenhäger; Pols, Huibert A. P.

doi:10.1359/jbmr.1997.12.1.152

Cited by 234 publications

(167 citation statements)

References 23 publications

(16 reference statements)

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“…All women except four, who wanted to take part, had however not been investigated earlier for their height shortening and had also no current history of back pain leading to medical examination, why the group was valuable to investigate. The prevalence of spinal fractures in our material was 45% which seems high compared to other studies where prevalence values from two to 39% have been demonstrated in men and women in different countries ( 1,8,(12)(13)(14)(15)(16). However, those studies were prevalence investigations in contrast to our trial comprising women with known height loss.…”

Section: Discussioncontrasting

confidence: 61%

Height Loss in Women Caused by Vertebral Fractures and Osteoporosis

Eggertsen¹,

Mellström²

2007

Upsala Journal of Medical Sciences

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Background: To investigate women, with height loss of more than three cm, without earlier diagnosed spinal fractures, for osteoporosis and vertebral fractures.Methods: Consecutively enrolment of women aged 50-85 years with a height loss of three cm or more. 80 women with a mean age of 70 years old (51-84) were recruited. Determination was made of bone mineral density (BMD) with DXA technique on hip, lumbar spine and whole body. Lateral spine radiographs were performed on thoracic and lumbar spine.Results: Mean height loss was 5.2 cm. Smaller vertebral fractures were diagnosed in 45% (n=36). All had osteopenia or osteoporosis on BMD measurements, and there were significant differences in T-score for hip and lumbar spine and in BMD, for the hip in subjects with and without vertebral compression.Conclusions: Women with height loss without knowledge of earlier spinal fractures could be suspected for osteoporosis and vertebral fractures

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Section: Discussioncontrasting

confidence: 61%

Height Loss in Women Caused by Vertebral Fractures and Osteoporosis

Eggertsen¹,

Mellström²

2007

Upsala Journal of Medical Sciences

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“…25 In those with SCI, 55% (11 of the 20 subjects) had mild to moderate DJD and 25% (5 of the 20 subjects) had severe DJD of the L-spine. In contrast, in the control group, 40% (6 of the 15 subjects) had mild DJD and none had moderate or severe DJD of the L-spine.…”

Section: Discussionmentioning

confidence: 95%

Dual-energy X-ray absorptiometry overestimates bone mineral density of the lumbar spine in persons with spinal cord injury

et al. 2009

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Background: Bone mineral density (BMD) of the lumbar spine (L-spine) has been reported to be normal or increased in persons with chronic spinal cord injury (SCI). Objective: To determine BMD of the L-spine by dual-energy X-ray absorptiometry (DXA) and quantitative computerized tomography (qCT) in men with chronic SCI compared with able-bodied controls. Design: Cross-sectional, comparative study. Setting: Clinical research unit, Veterans Affairs Medical Center, Bronx, NY, USA and Kessler Institute of Rehabilitation, West Orange, NJ, USA. Methods: Measurements of the L-spine were made in 20 men with SCI and compared with 15 ablebodied controls. The DXA images were acquired on a GE Lunar DPX-IQ. The qCT images of the L-spine were acquired on a Picker Q series computerized tomographic scanner. Results: The mean ages for the SCI and control groups were 44±13 vs 42±9 years, and the duration of injury of the group with SCI was 14 ± 11 years. There were no significant differences between the SCI and control groups for L-spine DXA BMD (1.391±0.210 vs 1.315±0.178 g/m 2 ) or for L-spine DXA T-score (1.471 ± 1.794 vs 0.782 ± 1.481). L-spine qCT BMD was significantly lower in the SCI compared with the control group (1.296±0.416 vs 1.572±0.382 g/m 2 , P ¼ 0.05); the T-score approached significance (À1.838 ± 1.366 vs À0.963 ± 1.227, P ¼ 0.059). Subjects with moderate degenerative joint disease (DJD) had significantly higher T-scores by DXA than those without or with mild DJD. Conclusion: Individuals with SCI who have moderate to severe DJD may have bone loss of the L-spine that may be underestimated by DXA, reducing awareness of the risk of fracture.

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“…Visual assessment of vertebral fracture on plain radiographs is notoriously subjective [3] so semi-quantitative and quantitative schemes have been developed to measure vertebral body deformity as a more reproducible indicator of fracture [1,2,4,5].…”

Section: Introductionmentioning

confidence: 99%

Vertebral deformity arising from an accelerated “creep” mechanism

et al. 2012

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Introduction Vertebral deformities often occur in patients who recall no trauma, and display no evident fracture on radiographs. We hypothesise that vertebral deformity can occur by a gradual creep mechanism which is accelerated following minor damage. ''Creep'' is continuous deformation under constant load. Materials and methods Forty-five thoracolumbar spine motion segments were tested from cadavers aged 42-92 years. Vertebral body areal BMD was measured using DXA. Specimens were compressed at 1 kN for 30 min, while creep in each vertebral body was measured using an optical MacReflex system. After 30 min recovery, each specimen was subjected to a controlled overload event which caused minor damage to one of its vertebrae. The creep test was then repeated. Results Vertebral body creep was measurable in specimens with BMD \0.5 g/cm 2 . Creep was greater anteriorly than posteriorly (p \ 0.001), so that vertebrae gradually developed a wedge deformity. Compressive overload reduced specimen height by 2.24 mm (STD 0.77 mm), and increased vertebral body creep by 800 % (anteriorly), 1,000 % (centrally) and 600 % (posteriorly). In 34 vertebrae with complete before-and-after data, anterior wedging occurring during the 1st creep test averaged 0.07°(STD 0.17°), and in the 2nd test (after minor damage) it averaged 0.79°(STD 1.03°). The increase was highly significant (P \ 0.001). Vertebral body wedging during the 2nd creep test was proportional to the severity of damage, as quantified by specimen height loss during the overload event (r 2 = 0.51, p \ 0.001, n = 34). Conclusions Minor damage to an old vertebral body, even if it is barely discernible on radiographs, can accelerate creep to such an extent that it makes a substantial contribution to vertebral deformity.

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Vertebral Deformities and Functional Impairment in Men and Women

Cited by 234 publications

References 23 publications

Height Loss in Women Caused by Vertebral Fractures and Osteoporosis

Height Loss in Women Caused by Vertebral Fractures and Osteoporosis

Dual-energy X-ray absorptiometry overestimates bone mineral density of the lumbar spine in persons with spinal cord injury

Vertebral deformity arising from an accelerated “creep” mechanism

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